CAT/OP/PAN/1 90. The Subcommittee is concerned to note that none of the medical personnel who make initial contact with persons deprived of their liberty in all places of detention are familiar with the Istanbul Protocol. 91. The Subcommittee recommends that the State party sponsor effective training on the Istanbul Protocol for doctors and other health personnel working with persons deprived of their liberty to enable them to document and address injuries. The Subcommittee also recommends that the State party ensure the clinical independence of health-care providers to make certain that they are in a position to discharge this obligation (rule 25 of the Nelson Mandela Rules). 92. The Subcommittee visited the country’s National Institute of Mental Health and observed adequate facilities, medical care and work dynamics. The Subcommittee noted that restraints were not used and that there was a protocol requiring a social worker to refer any cases of injuries to the Public Prosecution Service. 93. The Subcommittee visited a nursing home that plays an important social role. The Subcommittee found that the facilities and sanitary conditions were acceptable. Patients with significant cognitive impairments such as those caused by Alzheimer’s disease or senile dementia were not restrained. VI. Groups of especially vulnerable persons deprived of their liberty A. Situation of women 94. To study the situation of women deprived of their liberty, the Subcommittee visited the Colón women’s prison, the holding centre for female migrants and the Criminal Investigation Directorate. Prisons 95. The Subcommittee found that the material conditions in the new women’s wing in Colón (part of the Nueva Esperanza prison complex), where there were 72 women deprived of their liberty, were considerably better than those in the facility in which the women had previously been housed within the same prison, in particular with regard to hygiene, light and ventilation. 96. However, the Subcommittee received numerous and consistent reports about the poor quality of the food and the erratic times at which it was served; the scarcity of leisure activities, opportunities for exercise, vocational workshops and opportunities for education; the lack of basic hygiene products, including sanitary napkins; the difficulty of gaining access to medical care, including gynaecological and other specialized care; and the lack of conjugal visits. The denial of such visits is a form of discrimination, as men in the same prison complex have the right to conjugal visits. 97. The Subcommittee recommends that, in accordance with rules 5 and 10 of the United Nations Rules for the Treatment of Women Prisoners and Non-custodial Measures for Women Offenders (the Bangkok Rules), the materials required to meet women’s specific hygiene needs be made available to women prisoners and that women prisoners be provided with gender-specific health-care services. 98. The Subcommittee learned from the interviews it conducted that there is no systematic policy of providing mothers with alternatives to detention. It also found that there are no prison units in which women can keep their children with them. According to information received by the Subcommittee, no prison in the country has such facilities. Nursing women are also unable to breastfeed their children. Not being able to take care of their children was a major source of stress for most of the women interviewed. The lack of social and psychological support and the difficulty of following up with the relevant institutions on the situation of their children exacerbate the situation considerably. GE.18-12640 13